More about kicking my therapist to the curb

Some of my comments in an email discussion with my support group about the letter I wrote to the therapist I'd decided wasn't working for me:

As for the way the preparatory phase kept dragging on and on without us ever actually doing EMDR...I would have been totally ok with that part if she had said, "Whoa, girl! It's going to take longer with you because we need to do a, b, and c to get you ready" -- and if we had actually done those things. Or if she would have said, "Since your dissociating is such a big problem, here's how we are going to address that." Instead, each time I asked her for specifics about preparing me, she would sidestep the issue with one of her little speeches that would never answer the question. But it usually worked to distract me. Then I'd get home and talk to my husband and he would point out that she still had never answered my questions, so I'd ask them the next time, only to get distracted by her non-answers...Now that my brain works better, it's easier to see through that shit.

I just realized something else. My husband read my letter and one of his comments was that June didn't realize that I'm not the typical client. None of us are or we wouldn't be part of this group. We don't just show up for our sessions; we read stuff; we discuss amongst ourselves; we grill speakers and authors with questions; etc. What I realized is that her speechifying and lecturing probably impresses the snot out of a lot of other people, but I was all, "Yeah, yeah, I know that already." When I would tell her a polite version of that, or ask her to recommend stuff for me to read so we could make more efficient use of our sessions, I think it really put her off her game. Also, I wasn't impressed with her knowledge because my attitude was, "Well, duh, I expect someone who claims to be an EMDR expert to actually know stuff!" So, instead, I was all, "What? Why is she is so clueless about how to treat people like me? She really thinks it's ok to touch me?"

 

Kicking EMDR Therapist to the curb

As the weeks went by, I grew increasingly more frustrated with June. I vented to Sheldon, discussed it at length with him, with some close friends and with my support group. Finally I decided I had given her far more chances than I should have. I wrote her this letter:

October 9, 2012

Dear June,

After a great deal of careful thought and introspection, followed by several discussions with my husband and with trusted friends, as well as additional reading about EMDR, I have come to the conclusion that it would be best to discontinue therapy with you. My husband suggested writing “an articulate letter” expressing my concerns. This is my attempt at such a letter, although I’m not sure how well I will manage the “articulate”.

[I wrote a paragraph, which I'm not including, explaining and describing my support group.]

Our combined experiences and study have taught us quite a bit about what makes therapy effective for us. We need our therapists to communicate in a way that inspires our trust and confidence in them. Obviously, safety is a big issue for all sexual trauma survivors. In order to feel safe, we need the assurance that not only do our therapists possess the necessary expertise, but that they also treat us with sensitivity and compassion. We recognize that what we require is no simple or easy thing. In fact, it is unfortunately far easier for even the most well-meaning therapists to inadvertently do the opposite, causing us to lose what confidence we may have had in them. I’m afraid that is what has happened with you and me.

The first troubling incident was when you touched my knee. I was shocked that a therapist would touch a sexual trauma survivor without warning or permission. Some of my friends considered this a “major red flag”. What we have all grown to expect is being asked something along the lines of, “Is it OK if I touch your knee? It might help calm and ground you.” Instead, what happened felt like a violation of my personal boundaries. Your response to my reaction -- both then and each time you have mentioned it since -- has been unsettling to say the least. You have given no indication of understanding how inappropriate your actions were.

Somewhat less troubling, but still a cause for concern, was the way in which you disagreed with my decision not to press charges against my rapists. I question the purpose of lecturing me thirty years after the fact, and I see no therapeutic value in what came across as an attempt to undermine my confidence in a decision I have never once regretted. What made it worse is that you know extremely little about the circumstances of my rape or my life at the time, yet you felt no qualms telling me what I should have done.

Then there was the issue of eye contact during therapy. The first time you mentioned this, I was both baffled and amused. Frankly, I was tempted to respond, “Duh! I’m a rape and incest survivor!” or to tell you about my friend who stared at her therapist’s shoes every session for an entire year...or my friend who studies the carpet intently...or the other friend who rarely faces her therapist...I was also tempted to mention what several PTSD experts advise therapists regarding this very issue, but surely you already know this far better than I do. Yet you seemed to find it remarkable that I do not feel comfortable maintaining constant eye contact with you. I simply do not understand.

You have also given the impression that you consider it at least somewhat unusual that I did not disclose the incest to my parents at the time that it was happening. You even stated that this should have received special comment in the report from the psychologist who recently tested me. Why would my non-disclosure be particularly significant when the majority of those incest victims who disclose do not do so until well into adulthood? Our reasons for remaining silent are so numerous and compelling that I am amazed at the courage of anyone who does speak up. I would expect a therapist who treats incest survivors to at least acknowledge this reality.

Your negative characterization of my therapeutic relationship with Randy struck me as unprofessional. What was especially offensive is that you made those remarks in the context of describing others’ perception of me and how I can be taken advantage of. I found this insulting to both Randy and me. I'm tempted to refute your statements, especially the one about him being “in over his head” with my trauma issues. However, this letter is already long enough. I know who I was three years ago; I know who I am now; I know how tremendously I benefitted from therapy. I also know that only an exceptional therapist could have gained my trust the way Randy has.

My biggest frustration about therapy in your office is that I cannot point to any positives that will outweigh or even balance out the negatives that concern me. I kept waiting to experience progress or benefit from our sessions. Instead, I have felt stuck in what seemed to be an increasingly longer preparatory phase that brought me no closer to actual treatment than when I first walked in your door.

It would seem to me that if my tendency to dissociate is so problematic, we should either have agreed that I am not a good candidate for EMDR, or our sessions should have focused directly on overcoming this barrier to treatment. Neither has been the case. Even if I did not have my other serious concerns, I would see no reason to waste your time and mine by continuing therapy together.

Sincerely,

Annie [mysterious last name that I'm not ready to disclose here]

cc: Randy [his last name]

 

Things are good!!

At the end of September 2012, I emailed my support group:

Whew, what a day!

It started with me oversleeping and having to race out of the house to get to my appointment with the psychiatrist. This was a follow-up appointment and it went really well. After a somewhat rocky start with nausea and two days in a row of migraines, I'm not only tolerating the zoloft well, but I'm beginning to reap the benefits of it, which are nothing short of amazing to me. The anxiety is pretty much gone; I've been sleeping better, without nightmares; I've felt much more optimistic; I seem better able to handle the emotional ups and downs of life. I know that I'm not yet experiencing the full effects but even now I feel so much more stable than I ever have.

On Monday, I started taking vyvanse, my new ADD med. It's been fairly amazing too. I knew I struggled a lot, but I had no idea how much. I went into the p-doc with a written list of all the improvements I'd noticed and he kept saying, "Your meds are working exactly the way they are supposed to." He started me on the lowest dose of vyvanse, so he upped it a little and also prescribed me a shorter acting med to take in the later afternoon right before the vyvanse starts wearing off.

I left feeling hugely encouraged.

Then I got home. My husband had taken the day off, and he and our two youngest boys were waiting for me, wanting to have a serious talk. Uh oh. Once I realized what they wanted to talk about, I actually felt somewhat relieved, because this conversation has been long overdue. I ended up explaining everything to them...that I had been raped in my early 20's...that I had PTSD and what that meant...why I have been seeing a therapist...that I had recently been tested and diagnosed with ADD...that I was on new meds...and then I let them ask any questions that they wanted to ask. We talked about all sorts of stuff, including my drinking (which has been way better, by the way...) The only thing I didn't tell them about is the incest. They had figured out some of the stuff on their own, just by living with me. (It's kinda obvious I have PTSD. Duh!) I apologized to both boys about not being more open with them, and we talked about my family's legacy of secrecy and how I am trying to overcome that. It was a great talk!! Randy would be so proud of us!

After that, we ate hamburgers and made all sorts of jokes about getting diagnosed with a variety of learning disorders and quirky syndromes so that we could have excuses for all our behaviors.

Then we did work around the house. My husband and I even tackled a project that, before the vyvanse, would have so overwhelmed me that I would have had a terrible meltdown. Instead, I worked away with him as if I was an almost normal person in a good mood! It was so shockingly different than the old me that we couldn't help commenting on it.

I slept fairly well last night.

This morning I keep thinking about all the positive changes in my life lately. Our marriage still needs work, but it is the best it has ever been. It looks like I've found the right meds for my PTSD and my ADD. Our family is becoming more and more connected and open...and a lot of healing is taking place. Good, good stuff! God is really working.

At the same time, it's kinda scary. But, then again, everything is kinda scary to me!

 

Thoughts about my new diagnosis

Written in September 2013:

I've been mulling over what the diagnosis of ADD means to me, and why I have this huge jumble of emotions about it.

In a big way, it's a huge relief. It's something I would suspect, but then I would tell myself, "It's all in your imagination. Your real problem is that you are stupid, lazy, etc., etc."

Now I know a lot of that stuff was not my fault. And, it seems like I can make sense of things that have baffled and frustrated me since I was a kid.

In school, my teachers would say that I made "careless errors". This was so frustrating, because I felt as if I was being accused of not trying, of not caring, and the opposite was true. To this day, I can work very hard on writing something, proofread it a number of times, and it will still contain baffling typos and errors. It's become somewhat of a joke that almost anything I hand out to my students will contain at least one obvious error, unless someone else checks it. Usually I say upfront, "I'm sure there are mistakes, because I'm world's worst proofreader." Does this mean I don't care? Hardly. I hate those mistakes and typos.

When I would clean my room as a child, trying to do my very best with the hopes that my mother would finally, for once, be pleased at the result, she would immediately notice things like a shirt sleeve hanging out of the drawer, some toys in a corner, even a dirty sock in the middle of the floor. I could have sworn that I carefully inspected the room and found nothing amiss. How could I not have noticed these things? My mother would be so frustrated at me. She couldn't believe that I didn't do this sort of thing on purpose, just to annoy her. "Are you blind?" she would ask. "Why do you call me in to inspect your room when it's still a mess?"

I have always wondered why things that seem so easy to other people seemed so hard, almost impossible, to me. Am I stupid? Dense? Weird? People would say, "You must not be paying attention or this would be so easy for you!" but that only made things worse. I thought I was paying attention.

My husband has been forever frustrated and baffled as to why my life seems in a constant state of disorganized chaos, despite my best attempts over the years to correct this. I own numerous books about organizing, both personal and household, and I've tried -- and failed at -- numerous systems over the years. He has seen this as a lack of effort on my part, a lack of follow through. The truth is that I've tried and tried and tried, only to finally give up in despair, hoping that maybe the next book or the next system will work for me.

He has never understood why things will overwhelm me. A typical example: I decide to clean out the closet. He says, "Great idea! And, while we're at it, why don't we clean the entire bedroom and organize all our drawers?" He is an amazing super being and could actually tackle such a project. So he starts pulling everything out and then I'm fighting tears because, to me, he might as well say, "If you tried hard enough, you could organize every house in the neighborhood in one day!" I simply don't know where to start. The closet alone was already too overwhelming.

I feel like going back to every one of my teachers, from elementary school through high school, and saying, "I have ADD. So there. I wasn't bad, lazy, unmotivated, uncaring, or slow."

It makes me want to cry, thinking about it. I was trying. I was trying very hard. And when all those intense efforts never seemed to pay off, when I was accused of being sloppy or difficult or lazy, can anyone blame me for deciding not to push myself so hard? What is the use of trying if it's never good enough?

I think the biggest deal for me is knowing that I'm not stupid. Maybe I'll finally stop berating myself about that.

When I was a kid and my mother would be at wits' end with me, she would go on and on about how stupid I was. But, at report card time, I would get in trouble for my grades. If I was like one of my kids, I would have seen the irony in that and would have said, "Either I'm so terribly stupid, or I'm lazy for not getting straight A's. You can't have it both ways." But, instead, I grew up thinking that I was stupid and lazy.

At the same time, I can understand why I drove my mother to such frustration.

I've taught a number of kids with ADHD. They tend to do well, maybe because I refuse to label them or treat them like their diagnosis. Some of them, along the way, make me want to rip my hair out at times. But I've always had a soft spot for the kid who is bouncing all over while thinking he's standing still, or for the dreamy kid who has to be brought back to earth every few minutes. I wasn't the bouncing off the wall type, but I can relate to thinking you're doing well at something only to get in trouble for failing. One of my students once said, "I focused really well today, didn't I?" and I didn't have the heart to tell him that, to everyone else, it seemed as if he had been inhabiting a different planet during class. Now I know why I relate so well to those kids. I'm one of them.

Maybe best of all, the next time I blast myself with, "What the hell is wrong with you? You are such a complete loser!!" I can remind myself that I now know what's wrong with me, and I'm not a loser.

 

Results from psychological testing

More from September 2012, an email I wrote to my support group:

I'm having another insomnia bout, so I'm not sure if the following will make sense.

My husband and I met with the psychologist on Tuesday so that he could explain the results of the extensive psychological testing I had done. There were no major surprises. I already knew I had PTSD, and I suspected mine was not the mildest case, and he confirmed that. In fact, he strongly suggested I pursue additional treatment, and he gave me the name of a psychiatrist that could determine whether or not I would benefit from other meds. I have an appointment with the psychiatrist on Monday.

The next diagnosis was something I'd suspected for years, but now it's official: I have ADD, the inattentive type. He didn't just base that on screening and personal history; it was very clear from the testing itself. I asked whether or not it could just be another symptom of PTSD and he said, in my case, the difference was obvious. The attention issues with PTSD tend to be as a result of being distracted because of hypervigilance or as a result of dissociation. My test results demonstrated that my main attention problems are significantly different, even though I may also experience PTSD-related attention issues.

There were a few small surprises. I thought I'd done horribly on the test where I had to listen to one-digit numbers being read, add them together, and say the answer. That had been the most stressful part of the test for me. Amazingly, he said I did fine.

Not so with the test where I sat in front of a computer screen and hit the spacebar whenever a letter appeared, unless it was the letter "X". Sometimes the letter would appear in rather quick succession, other times it would be at varying intervals of time. The program measures the types of errors made, how long it takes for the person to respond, etc. The test lasted a horrendously tedious 10 minutes. Apparently a person without any attention or focusing problems will get better as the test goes on. People with different types of ADHD/ADD, or other attention issues, will make distinctively different types of errors. Mine were apparently rather significant, to the extent that the psychologist recommended I consider meds for ADD as well. His only concern, which he knows the psychiatrist will take into consideration, is that stimulants may make my PTSD worse. He emphasized that treatment for PTSD needed to take precedence, because that was my more debilitating issue.

I think it was really good that my husband was there. He described some of the things that have baffled and frustrated him about me, and the psychologist said, "That's classic ADD." What I especially appreciated is that he emphasized to my husband the extreme effort it takes for me to stay focused on most tasks, and he explained why it's pretty much impossible for me to multi-task.

He also went over the results of my personality test and explained to my husband how I am "hardwired" certain ways and that these are unchangeable. Guess I'll never be one of those eternally cheerful, upbeat, life of the party types.

I'm glad I had the testing done. At least now, I can't tell myself that my ADD symptoms are all in my head and that my real problem is that I'm stupid, lazy, or a nutcase. The next time my mother asks, "Are you sure you aren't bipolar?" I can explain that I was extensively tested and no, I'm not. My husband now knows that I don't do certain things in order to annoy him or because I don't care about him. The next time I worry about being crazy, I can remind myself that my test results prove otherwise. So, over all, I think it was money well spent. So does my husband, and he was the one paying for it.

As for the upcoming psychiatrist appointment...I'm a little bit nervous. I'm afraid of going through some awful trial and error in order to find the right meds. I'm scared of certain side effects. I don't want to become a chemical soup. At the same time, if I can be put on something that will alleviate some of my PTSD symptoms, that would be great. And being able to focus better would be...well, I have no idea what it would be like, because I've never experienced it!

In other news, my session with June, the EMDR therapist, also on Tuesday, went well. I brought in a thing I'd written detailing all my PTSD symptoms. I told her that I'd been frustrated by the screening thing she'd used and that I hadn't known how to answer the questions. She appreciated what I wrote, read it over, and asked me questions. For the first time, I felt that she was really listening to me and that she had a desire to get to know me as a person and not just as "EMDR client number whatever". And...she didn't do or say anything annoying the entire time!!!!

Next Tuesday morning I get to see Randy and fill him in on everything that's been going on. It seems like forever since I've seen with him.

For the most part, I feel hopeful that things are getting better. At the same time, I've been plagued by nightmares and sleep problems. Ugh.